Skip to main content
Top
Published in: Breast Cancer Research and Treatment 1/2021

01-02-2021 | Alopecia | Clinical trial

A phase I safety study of topical calcitriol (BPM31543) for the prevention of chemotherapy-induced alopecia

Authors: Mario E. Lacouture, Hedy Dion, Shobha Ravipaty, Joaquin J. Jimenez, Khampaseuth Thapa, Eric M. Grund, Ely Benaim, Nikunj Tanna, Shen Luan, Nathaniel DiTommaso, Niven R. Narain, Rangaprasad Sarangarajan, Elder Granger, Brian Berman, Shari B. Goldfarb

Published in: Breast Cancer Research and Treatment | Issue 1/2021

Login to get access

Abstract

Purpose

Chemotherapy-induced alopecia (CIA) negatively affects psychosocial health and quality of life (QoL). Currently, there are no approved pharmacologic agents to prevent CIA. Here, we evaluated the safety, tolerability, and potential signal of efficacy of topical calcitriol (BPM31543) on CIA prevention.

Materials and methods

This Phase 1 trial included 23 female patients with breast cancer, gynecologic cancer, or sarcomas receiving a taxane-based chemotherapy. Patients received a 3 + 3 dose-escalation regimen at 5, 10, 20, 40, 60, and 80 μg/mL, with 3–6 patients per group. Patients applied topical BPM31543 to the scalp twice a day for 2 weeks prior to chemotherapy and continued until chemotherapy treatment was completed. The maximum tolerated dose (MTD) during first 28 day application was determined. Adverse event (AE) monitoring, pharmacokinetics, blinded photographic assessments, and patient self-assessment were evaluated.

Results

Out of 23 patients treated with BPM31543, 8 patients experienced at least 1 treatment-related adverse event (AE). The majority of AEs were mild to moderate in severity. Only 1 patient experienced SAEs (vomiting, nausea, fever, and flank pain) considered treatment related. Alopecia < 50% from baseline was observed in 8 patients at Week 7, and, of which 2 patients had < 50% alopecia maintained at Week 15. There were no detectable effects of topical BPM31543 on serum levels of calcitriol.

Conclusions

BPM31543 applied topically twice daily to the scalp is safe and well tolerated in patients receiving taxane-based chemotherapy. No DLT was observed at up to 80 µg/mL, and MTD was not reached. Based on the data from this trial, BPM31543 represents a promising therapy and warrants further investigation in Phase 2/3 trials.
Appendix
Available only for authorised users
Literature
1.
go back to reference Trüeb RM (2010) Chemotherapy-induced alopecia. Curr Opin Support Palliat Care 4(4):281–284CrossRef Trüeb RM (2010) Chemotherapy-induced alopecia. Curr Opin Support Palliat Care 4(4):281–284CrossRef
2.
go back to reference Kim IR, Cho J, Choi EK et al (2012) Perception, attitudes, prepardedness and experience of chemotherapy-induced alopecia among breast cancer patients: a qualitative study. Asian Pac J Cancer Prev 13(4):1383–1388CrossRef Kim IR, Cho J, Choi EK et al (2012) Perception, attitudes, prepardedness and experience of chemotherapy-induced alopecia among breast cancer patients: a qualitative study. Asian Pac J Cancer Prev 13(4):1383–1388CrossRef
3.
go back to reference Wang J, Lu Z, Au JL (2006) Protection against chemotherapy-induced alopecia. Pharm Res 23(11):2505–2514CrossRef Wang J, Lu Z, Au JL (2006) Protection against chemotherapy-induced alopecia. Pharm Res 23(11):2505–2514CrossRef
4.
go back to reference West H (2017) Chemotherapy-induced hair loss (alopecia). JAMA Oncol 3(8):1147CrossRef West H (2017) Chemotherapy-induced hair loss (alopecia). JAMA Oncol 3(8):1147CrossRef
5.
go back to reference Lombardi D, Crivellari D, Scuderi C et al (2004) Long-term, weekly one-hour infusion of paclitaxel in patients with metastatic breast cancer: a phase II monoinstitutional study. Tumori 90(3):285–288CrossRef Lombardi D, Crivellari D, Scuderi C et al (2004) Long-term, weekly one-hour infusion of paclitaxel in patients with metastatic breast cancer: a phase II monoinstitutional study. Tumori 90(3):285–288CrossRef
6.
go back to reference Gasparini G, Gion M, Mariani L et al (2007) Randomized Phase II trial of weekly paclitaxel alone versus trastuzumab plus weekly paclitaxel as first-line therapy of patients with Her-2 positive advanced breast cancer. Breast Cancer Res Treat 101(3):355–365CrossRef Gasparini G, Gion M, Mariani L et al (2007) Randomized Phase II trial of weekly paclitaxel alone versus trastuzumab plus weekly paclitaxel as first-line therapy of patients with Her-2 positive advanced breast cancer. Breast Cancer Res Treat 101(3):355–365CrossRef
7.
go back to reference Kang D, Kim IR, Choi EK et al (2019) Permanent chemotherapy-induced alopecia in patients with breast cancer: a 3-year prospective cohort study. Oncologist 24(3):414–420CrossRef Kang D, Kim IR, Choi EK et al (2019) Permanent chemotherapy-induced alopecia in patients with breast cancer: a 3-year prospective cohort study. Oncologist 24(3):414–420CrossRef
8.
go back to reference Nangia J, Wang T, Osborne C et al (2017) Effect of a scalp cooling device on alopecia in women undergoing chemotherapy for breast cancer: the SCALP randomized clinical trial. JAMA 317(6):596–605CrossRef Nangia J, Wang T, Osborne C et al (2017) Effect of a scalp cooling device on alopecia in women undergoing chemotherapy for breast cancer: the SCALP randomized clinical trial. JAMA 317(6):596–605CrossRef
9.
go back to reference Kruse M, Abraham J (2018) Management of chemotherapy-induced alopecia with scalp cooling. J Oncol Pract 14(3):149–154CrossRef Kruse M, Abraham J (2018) Management of chemotherapy-induced alopecia with scalp cooling. J Oncol Pract 14(3):149–154CrossRef
10.
go back to reference Xie Z, Komuves L, Yu QC et al (2002) Lack of the vitamin D receptor is associated with reduced epidermal differentiation and hair follicle growth. J Invest Dermatol 118(1):11–16CrossRef Xie Z, Komuves L, Yu QC et al (2002) Lack of the vitamin D receptor is associated with reduced epidermal differentiation and hair follicle growth. J Invest Dermatol 118(1):11–16CrossRef
11.
go back to reference Verstuyf A, Carmeliet G, Bouillon R, Mathieu C (2010) Vitamin D: a pleiotropic hormone. Kidney Int 78(2):140–145CrossRef Verstuyf A, Carmeliet G, Bouillon R, Mathieu C (2010) Vitamin D: a pleiotropic hormone. Kidney Int 78(2):140–145CrossRef
12.
go back to reference Hoot J, Sadeghpour EJC (2018) Nonscarring alopecia associated with vitamin D deficiency. Cutis 102(1):53–55PubMed Hoot J, Sadeghpour EJC (2018) Nonscarring alopecia associated with vitamin D deficiency. Cutis 102(1):53–55PubMed
13.
go back to reference Bikle DD, Elalieh H, Chang S et al (2006) Development and progression of alopecia in the vitamin D receptor null mouse. J Cell Physiol 207(2):340–353CrossRef Bikle DD, Elalieh H, Chang S et al (2006) Development and progression of alopecia in the vitamin D receptor null mouse. J Cell Physiol 207(2):340–353CrossRef
14.
go back to reference Lisse TS, Saini V, Zhao H et al (2014) The vitamin D receptor is required for activation of cWnt and hedgehog signaling in keratinocytes. Mol Endocrinol 28(10):1698–1706CrossRef Lisse TS, Saini V, Zhao H et al (2014) The vitamin D receptor is required for activation of cWnt and hedgehog signaling in keratinocytes. Mol Endocrinol 28(10):1698–1706CrossRef
15.
go back to reference Kong J, Li XJ, Gavin D et al (2002) Targeted expression of human vitamin D receptor in the skin promotes the initiation of the postnatal hair follicle cycle and rescues the alopecia in vitamin D receptor null mice. J Invest Dermatol 118(4):631–638CrossRef Kong J, Li XJ, Gavin D et al (2002) Targeted expression of human vitamin D receptor in the skin promotes the initiation of the postnatal hair follicle cycle and rescues the alopecia in vitamin D receptor null mice. J Invest Dermatol 118(4):631–638CrossRef
16.
go back to reference Brown AJ, Slatopolsky E (2008) Vitamin D analogs: Therapeutic applications and mechanisms for selectivity. Mol Aspects Med 29:433–452CrossRef Brown AJ, Slatopolsky E (2008) Vitamin D analogs: Therapeutic applications and mechanisms for selectivity. Mol Aspects Med 29:433–452CrossRef
17.
go back to reference Jimenez JJ, Yunis AA (1992) Protection from chemotherapy-induced alopecia by 1,25-dihydroxy vitamin D3. Cancer Res 52(18):413–415PubMed Jimenez JJ, Yunis AA (1992) Protection from chemotherapy-induced alopecia by 1,25-dihydroxy vitamin D3. Cancer Res 52(18):413–415PubMed
18.
go back to reference Hidalgo M, Rinaldi D, Medina G et al (1999) A phase I trial of topical topitriol (calcitriol, 1,25-dihydroxyvitamin D3) to prevent chemotherapy-induced alopecia. Anticancer Drugs 10:393–395CrossRef Hidalgo M, Rinaldi D, Medina G et al (1999) A phase I trial of topical topitriol (calcitriol, 1,25-dihydroxyvitamin D3) to prevent chemotherapy-induced alopecia. Anticancer Drugs 10:393–395CrossRef
19.
go back to reference Bleiker TO, Nicolaou N, Traulsen J et al (2005) “Atrophic telogen effluvium” from cytotoxic drugs and a randomized controlled trial to investigate the possible protective effect of pretreatment with a topical vitamin D analogue in humans. Br J Dermatol 153(1):103–112CrossRef Bleiker TO, Nicolaou N, Traulsen J et al (2005) “Atrophic telogen effluvium” from cytotoxic drugs and a randomized controlled trial to investigate the possible protective effect of pretreatment with a topical vitamin D analogue in humans. Br J Dermatol 153(1):103–112CrossRef
Metadata
Title
A phase I safety study of topical calcitriol (BPM31543) for the prevention of chemotherapy-induced alopecia
Authors
Mario E. Lacouture
Hedy Dion
Shobha Ravipaty
Joaquin J. Jimenez
Khampaseuth Thapa
Eric M. Grund
Ely Benaim
Nikunj Tanna
Shen Luan
Nathaniel DiTommaso
Niven R. Narain
Rangaprasad Sarangarajan
Elder Granger
Brian Berman
Shari B. Goldfarb
Publication date
01-02-2021
Publisher
Springer US
Published in
Breast Cancer Research and Treatment / Issue 1/2021
Print ISSN: 0167-6806
Electronic ISSN: 1573-7217
DOI
https://doi.org/10.1007/s10549-020-06005-6

Other articles of this Issue 1/2021

Breast Cancer Research and Treatment 1/2021 Go to the issue
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine